Impact of Normal Weight Central Obesity on Clinical Outcomes in Male Patients With Premature Acute Coronary Syndrome

Angiology ◽  
2019 ◽  
Vol 70 (10) ◽  
pp. 960-968 ◽  
Author(s):  
Jindong Wan ◽  
Peng Zhou ◽  
Dan Wang ◽  
Sen Liu ◽  
Yi Yang ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Central Obesity ◽  
Normal Weight ◽  
Coronary Syndrome ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cerebrovascular Events ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Male Patients

There is a lack of studies that evaluate the association between normal weight central obesity and subsequent outcomes in patients with premature acute coronary syndrome (ACS). We evaluated 338 consecutive male patients (aged ≤ 55 years) with premature ACS. The primary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE). We compared the hazard ratios (HRs) in patients with and without normal weight central obesity using multivariable Cox proportional hazard models. All-cause mortality (16.8%) of patients with normal weight central obesity was much higher than those (7.1%) without normal weight central obesity ( P = .008). The incidence of MACCE in patients with and without normal weight central obesity were 40.7 and 23.6% ( P = .001), respectively. After multivariable adjustment, the risks of all-cause mortality and MACCE were significantly higher in patients with normal weight central obesity than those without normal weight central obesity (adjusted HR: 1.83; 95% confidence interval [CI]: 1.04-3.31; P = .004 and adjusted HR: 1.62; 95% CI: 1.18-2.27; P = .017, respectively). In conclusion, the risks of all-cause mortality and MACCE were significantly higher in male patients with premature ACS with normal weight central obesity than in those without normal weight central obesity.

scholarly journals GENDER DIFFERENCES IN MYOCARDIAL REVASCULARIZATION IN INDIVIDUALS WITH ACUTE CORONARY SYNDROME AFTER CORONARY ARTERY BYPASS SURGERY

2021 ◽  
Vol 1 (6(70)) ◽  
pp. 22-29
Author(s):  
F. Ibrahimov
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Acute Coronary Syndrome ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Female Patients ◽  
Coronary Syndrome ◽  
Cerebrovascular Events ◽  
Male Patients ◽  
The Difference

The purpose of this study was to study the gender differences in the frequency of major cardiovascular and cerebrovascular events (MACCE), cardiac mortality, mortality from all other causes, and to study the relationship between these conditions and risk factors in patients after CABS. Materials and methods. The study included 717 patients after the CABS, of whom 596 were male and 121 female. Patients admitted to hospital with acute coronary syndrome (ACS) and only those undergoing CABS surgery participated in the study. All clinical data on demographic characteristics, risk factors, and complications were selected and the survival and mortality analysis was performed retrospectively. The results. In assessing the age indicator, it was found that females (59.9±7.3 years) were significantly older than males (56.3±8.2 years) (p=0.00012). In the estimation of the 30-day mortality rate, it was shown that this indicator was 3.4% for women and 0.5% for men, the differences were statistically significant (p=0.004). Identical differences were also observed for 1-year mortality, as this indicator was 3.5% for women, while for men it was 0.7% and significantly lower (p=0.012). The 5-year MACCE percentage was 19% for women and 16.9% for men, i.e. the difference was not statistically significant (p=0.585). Conclusion. The main finding of this study was the difference between the profiles of female and male populations of preoperative patients after CABS. As in other studies in this area, and in this study, female patients were older, more likely to have AH, DM, obesity and anaemia than male patients.

Abstract 069: Sporadic Step Accumulation And All-cause Mortality In The Women’S Health Study: Do All Steps Count?

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Christopher C Moore ◽  
Kelly R Evenson ◽  
Eric J Shiroma ◽  
Annie G Howard ◽  
Carmen C Cuthbertson ◽  
...  
Keyword(s):  
Health Study ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Before And After ◽  
Step Counting ◽  
Cox Proportional Hazard Models ◽  
Restricted Cubic Splines ◽  
The Relationship

Background: With the popularity of step counting and feasibility of accumulating physical activity (PA) through sporadic spurts (e.g., taking the stairs), the 2018 PA Guidelines Committee called for research to inform step-based PA recommendations by quantifying relationships between patterns of stepping and health. Purpose: To examine the relationship between daily steps accumulated outside of “bouts” (sporadic steps/d) and all-cause mortality, before and after accounting for bouted steps/d. Methods: From 2011-2015, 16,732 women (mean 72 [standard deviation 6] years) wore a hip-worn accelerometer for 7 days to assess steps and met wear time criteria. Stepping bouts were defined as ≥10 consecutive minutes at ≥40 steps/min (purposeful stepping or faster), allowing for ≤20% of time and ≤5 mins at <40 steps/min. Total steps/d were partitioned into steps accrued outside of bouts (sporadic steps/d; SS) and in bouts (bouted steps/d; BS). We estimated hazard ratios (HRs) for mortality through Dec 31, 2019 using Cox proportional hazard models fitted to SS in quartiles and using restricted cubic splines. Analyses were adjusted for covariates and repeated with further adjustment for BS, categorized as 0, 1-2000, and >2000 steps/d in bouts. Results: Adjusted HRs (95% confidence intervals) in increasing quartiles of SS were 1.00 (reference); 0.63 (0.52, 0.76); 0.60 (0.49, 0.74); 0.54 (0.42, 0.70). In spline analyses, initial increases in SS corresponded to the greatest mortality reductions (Figure 1), with HRs of 0.69 (0.64, 0.76) per additional 1000 SS below 3200. After further adjusting for BS, initial 1000 steps/d increases in SS were association with HRs of 0.72 (0.66, 0.78). In increasing categories of BS, HRs adjusted for SS were 1.00 (reference); 0.91 (0.76, 1.09); 0.69 (0.56, 0.84). Conclusion: Daily step counts were inversely associated with mortality, regardless of how they were accumulated. These results can help inform step-based target PA volumes that communicate the benefits of increasing everyday walking behaviors.

scholarly journals Periodontal Antibodies and All-Cause and Cardiovascular Disease Mortality

2019 ◽  
Vol 99 (1) ◽  
pp. 51-59 ◽  
Author(s):  
J. Qi ◽  
Z. Zihang ◽  
J. Zhang ◽  
Y.M. Park ◽  
D. Shrestha ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Igg Antibody ◽  
Actinomyces Naeslundii ◽  
Health And Nutrition ◽  
Cox Proportional Hazard ◽  
Disease Mortality ◽  
All Cause Mortality ◽  
Yellow Orange ◽  
Cox Proportional Hazard Models ◽  
Cvd Mortality

Periodontitis is positively linked to cardiovascular disease (CVD), diabetes, cancer, and increased mortality. Empirically derived clusters of IgG antibodies against 19 selected periodontal microorganisms have been associated with hyperglycemia. We further investigated associations between these serum IgG antibody clusters and all-cause and CVD mortality in a representative US population. Participants free of CVD and cancer and aged ≥40 y at baseline ( N = 6,491) from the Third National Health and Nutrition Examination Survey (1988 to 1994) were followed up until December 31, 2011. Antibodies were categorized into 4 clusters: red-green, orange-red, yellow-orange, and orange-blue. Over a 23-y follow-up, 2,702 deaths occurred, including 810 CVD-related deaths. In fully adjusted Cox proportional hazard models, the red-green cluster was positively associated with all-cause mortality (tertile 3 vs. tertile 1: hazard ratio [HR] = 1.43, 95% CI = 1.08 to 1.90, P = 0.015). The yellow-orange cluster was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.78, 95% CI = 0.63 to 0.97, P = 0.028) and CVD mortality (tertile 2 vs. tertile 1: HR = 0.57, 95% CI = 0.42 to 0.77, P = 0.005). The orange-blue cluster (composed of antibodies against Eubacterium nodatum and Actinomyces naeslundii) was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.55 to 0.78, P < 0.0001) and CVD mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.47 to 0.88, P = 0.007). These antibodies could predict prognosis or be potential intervention targets to prevent systemic effects of periodontal disease if further studies establish a causal relationship.

scholarly journals Predictors of outcome in pleomorphic xanthoastrocytoma

2020 ◽  
Author(s):  
Antonio Dono ◽  
Victor Lopez-Rivera ◽  
Ankush Chandra ◽  
Cole T Lewis ◽  
Rania Abdelkhaleq ◽  
...  
Keyword(s):  
Tumor Size ◽  
Postoperative Radiotherapy ◽  
Treatment Strategies ◽  
Pleomorphic Xanthoastrocytoma ◽  
Survival Outcomes ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Male Patients

Abstract Background Pleomorphic xanthoastrocytomas (PXA) are circumscribed gliomas that typically have a favorable prognosis. Limited studies have revealed factors affecting survival outcomes in PXA. Here, we analyzed the largest PXA dataset in the literature and identify factors associated with outcomes. Methods Using the Surveillance, Epidemiology, and End Results (SEER) 18 Registries database, we identified histologically confirmed PXA patients between 1994 and 2016. Overall survival (OS) was analyzed using Kaplan-Meier survival and multivariable Cox proportional hazard models. Results In total, 470 patients were diagnosed with PXA (males = 53%; median age = 23 years [14-39 years]), the majority were Caucasian (n = 367; 78%). The estimated mean OS was 193 months [95% CI: 179-206]. Multivariate analysis revealed that greater age at diagnosis (≥39 years) (3.78 [2.16-6.59], P &lt; .0001), larger tumor size (≥30 mm) (1.97 [1.05-3.71], P = .034), and postoperative radiotherapy (RT) (2.20 [1.31-3.69], P = .003) were independent predictors of poor OS. Pediatric PXA patients had improved survival outcomes compared to their adult counterparts, in which chemotherapy (CT) was associated with worse OS. Meanwhile, in adults, females and patients with temporal lobe tumors had an improved survival; conversely, tumor size ≥30 mm and postoperative RT were associated with poor OS. Conclusions In PXA, older age and larger tumor size at diagnosis are risk factors for poor OS, while pediatric patients have remarkably improved survival. Postoperative RT and CT appear to be ineffective treatment strategies while achieving GTR confer an improved survival in male patients and remains the cornerstone of treatment. These findings can help optimize PXA treatment while minimizing side effects. However, further studies of PXAs with molecular characterization are needed.

scholarly journals Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes

2021 ◽  
Vol 10 (7) ◽  
pp. 1401
Author(s):  
You-Ting Lin ◽  
Wei-Lun Huang ◽  
Hung-Pin Wu ◽  
Man-Ping Chang ◽  
Ching-Chu Chen
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Hba1c Level ◽  
Care Program ◽  
Good Glycemic Control ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
Hba1c Variability

Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of mean and variability of HbA1c with HF in patients with T2DM. Using Diabetes Share Care Program data, patients with T2DM who had mean HbA1c (HbA1c-Mean), and HbA1c variability (tertiles of HbA1c-SD and HbA1c-adjSD) within 12–24 months during 2001–2008 were included. The cutoffs of HbA1c-Mean were set at <7%, 7–7.9%, and ≥8%. Hazard ratios (HRs) for HF during 2008–2018 were estimated using Cox proportional hazard models. A total of 3824 patients were included, of whom 315 patients developed HF during the observation period of 11.72 years. The associated risk of HF increased with tertiles of HbA1c variability and cutoffs of HbA1c-Mean. In mutually adjusted models, HbA1c-Mean showed a consistent dose-response association with HF, while the association of HbA1c variability with HF disappeared. Among patients with HbA1c-Mean <7%, the associated risk of HF in patients with HbA1c variability in tertile 3 was comparable to patients with HbA1c-Mean ≥8%. In conclusion, mean HbA1c was an independent predictor of HF and not explained by HbA1c variability. In addition to absolute HbA1c level, targeting on stability of HbA1c in patients with good glycemic control was also important for the development of HF in patients with T2DM.

A comparison of the CKD-EPI, MDRD-4, and Cockcroft–Gault equations to assess renal function in predicting all-cause mortality in acute coronary syndrome patients

2013 ◽  
Vol 167 (5) ◽  
pp. 2325-2326 ◽  
Author(s):  
Emad Abu-Assi ◽  
Pamela Lear ◽  
Pilar Cabanas-Grandío ◽  
Mar Rodríguez-Girondo ◽  
Sergio Raposeiras-Roubin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Renal Function ◽  
Coronary Syndrome ◽  
All Cause Mortality

Abstract 12188: Intensive Glycemic Control in Patients With Acute Coronary Syndrome: Evidence From a Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Partha Sardar ◽  
Ramez Nairooz ◽  
Saurav Chatterjee ◽  
Jacob A Udell ◽  
Dharam J Kumbhani ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Random Effect ◽  
Intensive Glucose Control ◽  
Intensive Glycemic Control ◽  
Coronary Syndrome ◽  
All Cause Mortality ◽  
Glucose Management ◽  
Management Groups

Introduction: Hyperglycemia is associated with unfavorable prognosis in patients with acute coronary syndrome (ACS). Studies with intensive glycemic control in ACS patients have provided inconsistent results. A meta-analysis was performed to evaluate the effectiveness and safety of intensive glycemic control in patients with ACS. Methods: Search of PubMed, Cochrane CENTRAL, EMBASE, EBSCO, Web of Science and CINAHL databases from their inception through April 2014, identifying randomized controlled trials (RCTs) comparing the effects of intensive versus standard glucose management in patients with ACS. We calculated summary random-effect odds ratios (OR) and 95% confidence intervals (CI). Results: Results from 10 RCTs comprising 2,621 patients were analyzed. All-cause mortality between intensive versus standard glucose management groups did not differ significantly (OR 1.00, 95% CI 0.75-1.34). Similarly, no significant differences were observed between the comparator groups for the odds of cardiac mortality (OR 0.87, 95% CI, 0.67 to 1.12), recurrent myocardial infarction (OR 1.07, 95% CI, 0.76 to 1.52), or stroke (OR 1.20, 95% CI, 0.60 to 2.40). The risk of hypoglycemia (OR 5.95, 95% CI, 2.73 to 12.97; p<0.001) was significantly higher with intensive compared with standard glucose management. Conclusions: Intensive glucose control compared with standard care in ACS patients did not reduce mortality or morbidity, but significantly increased the risk of hypoglycemia. These data from prior clinical trials should be interpreted in the context of their significant methodological limitations.

scholarly journals A comparative study of serum adiponectin levels in patients of acute coronary syndrome with and without central obesity

2019 ◽  
Vol 6 (1) ◽  
pp. 66
Author(s):  
Shashank R. Tiwari ◽  
Lokesh S. ◽  
Arunprasath P. ◽  
Arun Kumar R.
Keyword(s):  
Acute Coronary Syndrome ◽  
Central Obesity ◽  
Adiponectin Level ◽  
Serum Adiponectin ◽  
South Indian Population ◽  
Coronary Syndrome ◽  
South Indian ◽  
Tertiary Center ◽  
The Mean ◽  
First Time

Background: Coronary artery disease burden has been on a rise globally with it emerging as the principle cause of death even in the Indian subcontinent. Serum adiponectin has recently gained interest due to its close relation with atherosclerotic CAD and Metabolic syndrome. The levels of serum adiponectin are reduced in ACS. There is a paucity of studies in South Indian population comparing the effect of central obesity in patient with ACS. The aim of the present endeavour was to study the association of serum adiponectin in risk evaluation of patient with acute coronary syndrome with and without central obesityMethods: The study was conducted in a tertiary center in patient who presented with first time ACS they were grouped into two groups based on the presence and absence of central obesity. Central obesity was defined on the basis of waist to hip ratio. Serum adiponectin levels were estimated in both the groups using ELISA method. The results were statistically analyzed using t- test.Results: Authors concluded that the mean age of patients presenting first time with ACS was 55±12years in both the group. There was a significantly raised LDL and Total Cholesterol (TC) level in patient with central obesity. The estimated serum adiponectin level was reduced in both the group with more significant reduction in group with central obesity. The mean adiponectin level in CAD patients with central obesity was 2.326±1.437µg/ml as compared to 3.486±1.6999μg/ml in patients without central obesity, which was statistically significant (p value <0.0049).Conclusions: Authors concluded that serum adiponectin levels were reduced in both the group with ACS with a further reduction in patient with central obesity. It was also observed that there was a significant relation between adiponectin level and visceral fat as compared to superficial fat, as adiponectin was significantly reduced in patient higher waist-hip ratio.

scholarly journals Dietary fiber intake and risk of prediabetes in China: results from the TCLSIH Cohort Study

2021 ◽  
pp. 1-20
Author(s):  
Shunming Zhang ◽  
Ge Meng ◽  
Qing Zhang ◽  
Li Liu ◽  
Zhanxin Yao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Dietary Fiber ◽  
Lower Risk ◽  
Fiber Intake ◽  
Soluble Fiber ◽  
Total Dietary Fiber ◽  
Dietary Fiber Intake ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models

Abstract High dietary fiber intake has been associated with a lower risk of diabetes, but the association of dietary fiber with prediabetes is only speculative, especially in China, where the supportive data from prospective studies is lacking. This study aimed to examine the association between dietary fiber intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18,085 participants of the TCLSIH cohort study who were free of diabetes, prediabetes, cancer, and cardiovascular disease at baseline. Dietary data were collected using a validated 100-item food frequency questionnaire. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 63,175 person-years of follow-up, 4,139 cases of incident prediabetes occurred. The multivariable HRs (95% CIs) of prediabetes for the highest versus lowest quartiles were 0.85 (0.75, 0.98) (P for trend =0.02) for total dietary fiber, 0.84 (0.74, 0.95) (P for trend <0.01) for soluble fiber, and 1.05 (0.93, 1.19) (P for trend =0.38) for insoluble fiber. Fiber from fruits, but not from cereals, beans, and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fiber, soluble fiber, and fiber derived from fruit sources were associated with a lower risk of prediabetes.

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